International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 3: extraprostatic extension, lymphovascular invasion and locally advanced disease

Abstract

made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to extraprostatic extension (pT3a disease), bladder neck invasion, lymphovascular invasion and the definition of pT4 were coordinated by working group 3. It was agreed that prostate cancer can be categorized as pT3a in the absence of adipose tissue involvement when cancer bulges beyond the contour of the gland or beyond the condensed smooth muscle of the prostate at posterior and posterolateral sites. Extraprostatic extension can also be identified anteriorly. It was agreed that the location of extraprostatic extension should be reported. Although there was consensus that the amount of extraprostatic extension should be quantitated, there was no agreement as to which method of quantitation should be employed. There was overwhelming consensus that microscopic urinary bladder neck invasion by carcinoma should be reported as stage pT3a and that lymphovascular invasion by carcinoma should be reported. It is recommended that these elements are considered in the development of practice guidelines and in the daily practice of urological surgical pathology.

International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 1: specimen handling

“…The results of the individual working group reports related to T2 substaging, extraprostatic extension, seminal vesicle and lymph node involvement and margin status are reported separately. [13][14][15][16] Many recommendations of this consensus conference have already been incorporated into international guidelines, including the recent College of American Pathologists protocol and checklist for reporting adenocarcinoma of the prostate and the structured reporting protocol for prostatic carcinoma from the Royal College of Pathologists of Australasia. 17,18 Specimen transportation Typically, radical prostatectomy specimens are transported in 10% buffered formal saline.…”

International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins

“…The results of the individual working group reports related to specimen handling, T2 substaging, extraprostatic extension and seminal vesicle and lymph node involvement are reported separately. [13][14][15][16] Many recommendations of this consensus conference have already been incorporated into international guidelines, including the recent College of American Pathologists protocol and checklist for reporting adenocarcinoma of the prostate, and the structured reporting protocol for prostatic carcinoma from the Royal College of Pathologists of Australasia. 17,18 Definition and criteria for positive surgical margins A positive surgical margin can be defined as tumor that extends to the surface of the prostate wherein the surgeon has cut across the tissue plane.…”

Multiparametric magnetic resonance imaging for pre-treatment local staging of prostate cancer: A Cancer Care Ontario clinical practice guideline

“…Explanations surround the lack of detail reported for radiology and pathology evaluation and interpretation, and the difficulty in distinguishing between microscopic to gross EPE. 48 Future studies should consider improvements in patient sampling and study design, standardized use of functional sequences, explicit pathology criteria, and blinding of both radiologists and pathologists. The impact of pre-treatment local staging by MRI ± DWI, DCE, MRS on clinical and patient outcomes is still not clear.…”